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Single loading dose versus standard 24-hour magnesium sulfate in women with severe preeclampsia and eclampsia: A systematic review and metaanalysis

Dirdrah Aina Crisostomo Salvador, MD and Floriza Crisostomo Salvador, MD, FPOGS, FPSUOG
Department of Obstetrics and Gynecology, De La Salle University Hospital

Objectives: The primary goal of this study is to determine if a single loading dose of Magnesium sulfate (MgSO4) is comparable to standard 24 hour therapy in preventing seizures with severe preeclampsia and eclampsia

Study Design: Metaanalysis and Systematic review of six randomized controlled trials

Patients/Subject Selection: Patients diagnosed with severe preeclampsia and eclampsia Intervention: Giving of single loading dose only (study group) versus 24-hour MgSO4 therapy (control) in patients with severe preeclampsia and eclampsia

Outcome Measures: (1) Anti-convulsant effects (2) Maternal: loss of deep tendon reflex and oliguria, incidences of caesarean section, Hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome, post partum hemorrhage and intensive care unit admissions and (3) Neonatal complications: incidences of neonatal intensive care unit (NICU) admission, APGAR score at 5 minutes and death

Results: Occurrence of seizures was similar in both groups. The risk difference of -0.00 (95% Confidence interval (CI): -0.04 to 0.03; p=0.84) showed no significant difference and the combined studies were found to be homogenous with an I2 of 0.0.

Conclusion: A single loading dose of MgSO4 is comparable in preventing seizures of preeclamptic and eclamptic patients with similar maternal and neonatal complications except for a lesser occurrence of decreased patellar reflex in the study group (p=<000001).